Author: Andrea

Matters of Appearance: Eating Disorder Patients’ Interpretations of Therapists’ Bodies

Andrea 11 Comments

Therapeutic alliance is often highlighted in studies looking at treatment effectiveness, both in and beyond the realm of eating disorder therapy. Evidently, there are a number of factors that can impact how well we get along with our therapists, ranging from disagreements with the course of treatment or type of therapy to a simple, unnamable dislike for the person. But what about their appearance? What kind of impact could a therapist’s body size have on the therapy relationship?

Rance, Clarke & Moller (2014) sought out to investigate this issue, looking specifically at how clients evaluate therapists’ body size and speculate on their relationship with food, with an eye to determine what impact this might have on the therapeutic process.

I was immediately drawn to this study when I was browsing the latest literature; I wondered why this hadn’t been studied before. In some ways it seems obvious; we’re … Continue reading →

Impossible Binaries? Eating Disorders Among Trans Individuals

Andrea 14 Comments

Recently I was doing some research for an upcoming (and very exciting)  endeavour that involves exploring eating disorders among LGBTQ individuals. As one does, I set about scouring the research literature in this area in the hopes of stumbling across some prior articles on which to hang my proverbial research hat.

As I sifted through the databases, however, my searches kept coming up short. After sending out a call to a list-serv enquiring about the state of the field in this area, I received many responses highlighting the gap that surrounds trans individuals in particular. While this is good news for arguing for the value in conducting research in this area, it is discouraging news when it comes to understanding and attending to the experiences of trans people with eating disorders.

All this is to say, it seems as though now is as good a time as any to dip … Continue reading →

In a Relationship and It’s Complicated: Eating Disorders in Intimate Relationships

Andrea 4 Comments

What would you do if your partner started restricting caloric intake or bingeing and purging? Would you know how to approach your partner, how to offer support? And what about your own mental health?

Coping with an eating disorder in the context of any relationship can be tricky. There is a growing body of literature that addresses ways to bolster support for caregivers. While this is encouraging, a number of these studies explore the experiences of “caregivers” as a generic category encompassing parents, spouses, and other relatives. Few studies focus on the experiences of spouses and significant others in particular.

Dick, Renes, Morotti & Strange (2013) looked at literature exploring eating disorders in the couple context in an effort to devise recommendations for clinicians working with couples. For their review, the authors honed in on the experiences of heterosexual couples where the female partner was diagnosed with anorexia … Continue reading →

Nothing to SCOFF at: Screening for Eating Disorders in the Emergency Room

Andrea

As many who have suffered from eating disorders know, these illnesses can often go unnoticed for years. Family members and friends might not be the only ones who don’t catch the signs and symptoms of EDs; doctors, too, may not identify the presence of an eating disorder. Whether or not sufferers desire to get help, the symptoms associated with eating disorders often lead many to present at doctors’ offices and emergency departments, suffering from “mysterious ailments.”

In a study by Dooley-Hash, Lipson, Walton & Cunningham (2012, 2013), 16% of youth 14-20 presenting to the emergency department screened positive for eating disorders. The researchers describe their study in two articles published in the International Journal of Eating Disorders in 2012 and 2013. For this post, I’ll focus on the 2013 article, which highlights the patterns of emergency department use of those who present with eating disorders.

Tetyana has previously written … Continue reading →

Narrative Therapy and Eating Disorders: Help or Hype?

Andrea 13 Comments

If you kick around the eating disorder recovery/treatment/research community for a while, you’re bound to come across someone calling their eating disorder “Ed.” In both the popular and scholarly literature around eating disorders, this externalizing and personifying approach has come to be quite popular. At face value, it makes sense to attribute blame for what can be an extremely difficult and painful experience to something other than oneself; it might be easier to “fight for recovery” if you have something to fight against.

But is there any evidence for the helpfulness of externalizing eating disorders? Who is “Ed,” and does “he” (or “she”) hold meaning for most or all sufferers? How might treatment programs make use of this construct in helping to facilitate clients’ recovery?

I will preface this post with a few disclaimers: firstly, I found a lot of solace in personifying my eating disorder early on in treatment … Continue reading →

Is Eating Disorder Prevention Possible?

Andrea 11 Comments

How did I ever find things to write about before social media? Recently, someone on Tumblr asked whether eating disorder prevention and awareness efforts do more harm than good. In other words, can attempting to prevent eating disorders actually contribute to their development? Good question, I thought. I’ve often wondered about this myself, especially in light of some emerging studies suggesting that “healthy eating” campaigns may actually contribute to unhealthy (restrictive) behaviours around food in school children. So off I went to scour the literature. I came up with a number of hits, but surprisingly few from the past few years. With this recent silence in mind, I will look specifically at a meta-analysis by Stice, Shaw & Marti published in 2007 that highlights some of the characteristics of effective prevention programs and comment on some of the potential pitfalls of prevention.

PREVENTION

As a bit of a primer prevention … Continue reading →

Complex Motherhood: The Perspectives of Mothers with Eating Disorders

Andrea 10 Comments

Studying, as I do, in a department of family relations, I have become interested in family relationships and parenting. Accordingly, I have begun to take note of interesting studies that link family dynamics and parenting with eating disorders, including studies that look at the sibling relationship (as I wrote about here), family-based treatment, and motherhood/fatherhood in the context of eating disorders.

The literature appears to have shifted, lately, from a focus on “eating-disorder generating” families toward an acknowledgement of the complex family dynamics that can play into the development and treatment of eating disorders. A move away from mother- or family-blaming discourses is essential, I would argue, to gaining a better understanding of the lived experience of eating disorders for individuals and families alike.

Accordingly, I was pleased to stumble across an article by Tuval-Mashiach et al. (2013) that used a qualitative approach to explore the experiences … Continue reading →

Dialectical Behavioural Therapy for the “Difficult to Treat” Eating Disorder Patients

Andrea

If there is anything we’ve learned over the  many years of eating disorder research, it is that eating disorders are extremely complex. Often, this complexity is intensified by comorbidities, including post-traumatic stress disorder, depression, and “personality disorders.” Unfortunately, individuals whose disorders are labeled persistent, chronic, or “difficult to treat” may be even less likely to receive the treatment and support they require, deserve, and desire.

“Standard” approaches to eating disorder treatment, such as cognitive behaviour therapy (CBT), may prove ineffectual for these individuals. In a recent article, Federici & Wisniewski (2013) reflected on the difficulty of treating patients whose eating disorders are accompanied by other mental health issues. They noted that focusing on ED symptoms alone generally fails to achieve treatment goals, as behaviours associated with other disorders often decrease ED treatment effectiveness. This situation may leave both patients and clinicians feeling burnt out and unsatisfied (to say … Continue reading →

Problematic Labelling: The Case of “Drunkorexia”

Andrea 9 Comments

Recently, I was browsing the Twittersphere and came across (yet another) tweet about so-called “drunkorexia,” or the phenomenon of drinking to excess coupled with restrictive behaviours around food. After firing off a mildly miffed tweet bemoaning our societal tendency to add the suffix “orexia” to all “new” potentially problematic behaviours around food, I took to Scholar’s Portal to see if academics, too, were using this term. I wondered if “drunkorexia” was piquing scholarly interest, or just circulating in media headlines.

Beyond its problematic moniker, coupling problem drinking and restrictive eating is a phenomenon that might be worth delving into in greater detail, particularly if, as the reports claim, its incidence is rising. Barry & Piazza-Gardner (2012) explored the co-occurrence of weight maintenance behaviours and alcohol consumption, and their article clarifies what people mean when they say “drunkorexia.” I’ll get more into my issues with this terminology following a … Continue reading →

The Art of Therapy: Using of Arts-Based Therapies in Eating Disorder Treatment

Andrea 7 Comments

Arts-based therapies are often used to supplement more “traditional” eating disorder treatment protocols in various different settings, ranging from individual therapy to inpatient units. However, as Frisch, Franko & Herzog (2006) note, no published research provides empirical support for the use of arts-based therapies for eating disorder treatment.

You might be wondering: if there is no empirical support, why are clinicians still using these therapeutic practices? You might also be wondering why I’ve chosen to dissect an article from 2006.

I’ll address the first question in this post (teaser: it’s really hard to say!). As for my delving back into the depths of academia, there is surprisingly little literature that touches on arts-based therapy, despite its continued use. This article provides an overview of why this might be, and where we can go from here.

WHAT IS ARTS-BASED THERAPY?

Arts therapy is an umbrella term used to refer … Continue reading →